Cardiometabolic Comorbidities And Survival Of Middle-Aged And Elderly Non-Small Cell Lung Cancer Patients

Objective:Both lung cancer and cardiometabolic diseases are leading causes of death in China and they share some common risk factors,which bring heavy burdens on society.This study aims to explore the prevalence and survival of cardiometabolic comorbidities on middle-aged and elderly non-small cell lung cancer(NSCLC)patients.Methods:This study recruited 3477 NSCLC patients between January 2011 and December 2018 in 3 cancer specialty hospitals and 1 general hospital in China.Cardiometabolic comorbidities in our study were defined as pre-existing cardiometabolic diseases when cancer was first diagnosed before treated.Survival analysis was demonstrated by Kaplan-Meier curves and the curves were compared with the log-rank test.Univariable and multivariable adjusted Cox proportional hazard models were conducted to evaluate the risk factors associated with mortality.Hazards ratios(HRs)for mortality and corresponding 95%confidence interval(95%CI)were calculated.Results:The prevalence of cardiometabolic comorbidities was 34.4%in the middle-aged and elderly NSCLC patients,30.0%in middle-aged NSCLC patients and 45.5%in elderly NSCLC patients.Log-rank analysis presented statistically differences of median survival time(MST)between patients with cardiometabolic comorbidities and without cardiometabolic comorbidities both in the middle-aged group(21.0 months VS 32.0 months,P<0.01)and elderly group(13.0 months VS 17.0 months,P=0.01).Heart failure(HR 1.754,95%CI 1.436-2.144,P<0.001)and venous thrombus embolism(HR 2.196,95%CI 1.691-2.853,P<0.001)were associated with worse prognosis in middle-aged NSCLC patients,while heart failure(HR 1.709,95%CI 1.371-2.130,P<0.001)decreased overall survival in elderly patients.Hyperlipidemia was associated with better prognosis in middle-aged patients(HR 0.741,95%CI 0.566-0.971,P=0.030).Conclusions:Cardiometabolic comorbidities are quite common in middle-aged and elderly NSCLC patients in China,which is closely related to long-time prognosis.The management of cardiometabolic comorbidities is of great significance for improving clinical outcomes and enriching the practice of cardio-oncology.